Diffuse spinal leptomeningeal spread of a pilocytic astrocytoma in a 3-year-old child

  • Ameer Alyeldien | dr.alyeldien@gmx.de Department of Neurosurgery, Sana Kliniken, Duisburg, Germany.
  • Sarah Teuber-Hanselmann Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany.
  • Azad Cheko Department of Neurosurgery, Sana Kliniken, Duisburg, Germany.
  • Tanja Höll Department of Pediatrics, Sana Kliniken, Duisburg, Germany.
  • Martin Scholz Department of Neurosurgery, Sana Kliniken, Duisburg, Germany.
  • Athanasios K. Petridis Department of Neurosurgery, Heinrich Heine University, Düsseldorf, Germany.


Pilocytic astrocytomas correspond to lowgrade gliomas and therefore metastasize exceedingly rare. However, pilocytic astrocytomas are able to and leptomeningeal dissemination may be seen. What are the treatment options of these cases? We present a case report of a 3-year-old child with a pilocytic astrocytoma of the optic chiasm with leptomeningeal dissemination of the spinal meninges. Partial resection of the cerebral tumor has been performed. Since the leptomeningeal dissemination was seen all over the spinal meninges, the child did not undergo further surgical treatment. A wait and watch strategy were followed. Chemotherapy was initiated, if a 25% tumor growth was seen. Leptomeningeal dissemination of a pilocytic astrocytoma is seen so infrequently that no standard therapy is established. Since these metastases may occur even up to 2 decades after primary tumor resection, long-term follow- up is indicated. In case of spinal metastases, surgical treatment should be performed if feasible. Otherwise observation should be possessed and/or chemotherapy should be initiated.


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Case Reports
Pilocytic astrocytoma, metastasis, spinal dissemination, optic chiasm.
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How to Cite
Alyeldien, A., Teuber-Hanselmann, S., Cheko, A., Höll, T., Scholz, M., & Petridis, A. K. (2016). Diffuse spinal leptomeningeal spread of a pilocytic astrocytoma in a 3-year-old child. Clinics and Practice, 6(1). https://doi.org/10.4081/cp.2016.813

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